Only a scant increase has been seen in utilization of the adult guardianship system, which is designed to support people with insufficient ability to make decisions for themselves, including elderly people with dementia. It is necessary to improve the operation of the system.
At present, the system is used by 224,000 people, which constitutes only a small portion of the estimated 6 million elderly people with dementia. One reason why is that guardians' activities tend to be focused on property management, not supporting the day-to-day life of the people they are looking after.
This month, a panel of experts at the Health, Labor and Welfare Ministry put together an interim report aimed at promoting use of the system. The report urged guardians to perform their duties by prioritizing as much as possible the standpoint of understanding the wishes of the people being assisted and protecting their daily lives.
The system is designed to authorize guardians chosen by family courts to manage the deposits and savings of the people being assisted and also sign various contracts on their behalf.
Guardians are expected to think about how nursing-care, welfare and medical services should be combined, depending on the condition of the people being assisted, to ensure they can receive appropriate care. The course of action set out in the report is understandable.
The key to realizing carefully attentive treatment for the people being looked after is whether guardians can be selected who are suited to the task.
Only 20 percent of the people selected as guardians last year were relatives of the people being assisted, and the rest were largely lawyers and judicial scriveners. This situation was influenced by the succession of past cases in which guardians selected from among the relatives of people being assisted embezzled their property.
Compared with relatives who are close to the people being looked after, however, it is difficult for personnel with professional expertise to grasp their charges' specific daily needs. It may be necessary to flexibly manage the system by enabling relatives to replace such professionals as guardians, while taking measures to prevent embezzlement.
It is also effective to divide the tasks involved by having relatives and professionals form pairs of selected guardians, with the former assigned to support the daily life of the people being assisted and the latter supervising their assets.
It is also important to consider the appropriate method for fee payments to guardians.
Generally, such fees are set by family courts at somewhere between 20,000 yen to 60,000 yen per month, in accordance with the amount of the assets possessed by the people being looked after. Criticism persists among users of the system, who have difficulty seeing the details of what guardians do, saying they do not understand why large fees must be paid. This is one reason people refrain from utilizing the system.
Last year, the Supreme Court told family courts nationwide to reconsider the method for determining the amount of fees in accordance with the volume of guardians' work and the degree of difficulty involved. They should make appropriate judgments to make the fees commensurate with the realities involved.
Local governments have a large role to play in this respect, as they support the system. Core organs set up at local governments to serve as sections in charge of various matters related to the system provide consultations for relatives who are considering using the system, while also fostering ordinary citizens who take care of people with no relatives despite having no personal kinship with them.
It is important for organizations of personnel with expertise, such as local governments, family courts and bar associations, to cooperate in the efforts to make the system easy to use.
-- The original Japanese article appeared in The Yomiuri Shimbun on March 22, 2020.
Read more from The Japan News at https://japannews.yomiuri.co.jp/
